福建省性传播艾滋病病毒感染者/艾滋病病人生存状况分析

目的 分析福建省性传播艾滋病病毒感染者（HIV）/艾滋病病人（AIDS）生存状况及其影响因素。方法 利用中国疾病预防控制信息系统艾滋病综合防治信息系统,收集自1987年福建省报告首例经性传播病例-2014年11月30日病例基本信息和随访资料,采用回顾性队列研究分析相关数据。结果 6 146例研究对象平均生存时间为（189.91±7.58）月,中位生存时间216月;首次确诊HIV抗体阳性时年龄<50组死亡风险低于年龄≥50岁组（P均<0.0001）;大专以上文化程度病例死亡风险低于其他文化水平患者（95%CI=0.20~0.87,P=0.020）,重点人群、羁押人群发现病例死亡风险低于医疗机构发现病例（P分别为0.010、0.046）;CD4⁺T淋巴细胞≤500个/μL病例死亡风险高于CD4⁺T淋巴细胞>500个/μL病例（P均<0.000 1,95%CI=19.04~83.03、6.17~28.33、1.89~8.26）;未治疗组死亡风险高于治疗组（P<0.000 1,95%CI=4.12~7.21）。结论 年龄、文化程度影响HIV/AIDS的生存时间。     

Conceptualizing Women's Attitudes Toward Condom Use with the Tripartite Model

Background: The Centers for Disease Control and Prevention (2011) estimated that women represent 24% of HIV diagnoses in the United States, with most infections resulting from heterosexual contact. However, consistent condom use is highly effective in preventing the spread of HIV. The current study examined women's attitudes toward condom use and potential inconsistencies related to the conceptualization and measurement of attitudes. Method: Data were collected from October 2009 through March 2010. Researchers included 556 female undergraduate students from the Southeast region of the United States. Exploratory and confirmatory factor analyses were used to determine whether women's condom use attitudes were composed of an affective and a cognitive component. Results: Evidence for a two-factor model of condom use attitudes consisting of an affective and cognitive component was found, with participants reporting slightly negative feelings toward condom use but favorable beliefs about using condoms. Affect accounted for more variance (42%) than cognition (8%) in condom use attitudes. Notably, affect and cognition were differentially associated with past behavior and intentions to use condoms. Conclusion: Understanding the structure of women's attitudes toward using condoms can aid in the creation of appropriate HIV prevention and condom use messaging targeted toward promoting positive attitudes and normative change. Changing women's attitudes in this manner could enhance the effectiveness of condom use interventions.     

The intentions of gay men in taking an HIV test

The objective of this study was to determine the contributions of a range of psychosocial, demographic and behavioural variables to gay men's intentions to take an HIV test. A cross‐sectional self‐report survey was undertaken. Researchers approached patrons of all known gay bars in Glasgow and Edinburgh during May 2000. Questionnaires were completed by 803 men (response rate of 78%). Those with a stronger intention to test had previously tested, and they were younger, with two or more recent unprotected anal sex partners. They perceived their HIV status to be unknown, had less fear of a positive test result, and perceived more benefits of testing. Intention to test in those with two or more recent unprotected anal sex partners was attenuated if accompanied by increased fear of a positive test result. Results are considered in the context of the theories of reasoned action and planned behaviour. Intention to test is far from a unitary phenomenon, and the existence of various sub‐groups within the gay population demands a new approach to both research and health promotion.     

The effect of sex work regulation on health and well‐being of sex workers: Evidence from Senegal

Senegal is the only African country where sex work is legal and regulated by a health policy. Senegalese female sex workers (FSWs) are required to register with a health facility and to attend monthly routine health checks aimed at testing and treating sexually transmitted infections (STIs). Compliance to those routine visits is recorded on a registration card that must be carried by FSWs in order to avoid sanctions in case of police arrests. Although this policy was first introduced in 1969 to limit the spread of STIs, there is no evidence so far of its impact on FSWs' health and well‐being. The paper aims to fill this gap by exploiting a unique data set of registered and unregistered Senegalese FSWs. Using propensity score matching, we find that registration has a positive effect on FSWs' health. However, we find that registration reduces FSWs' subjective well‐being. This finding is explained by the fact that registered FSWs are found to engage in more sex acts, in riskier sex acts, have less social support from their peers, and are more likely to experience violence from clients and police officers. We prove that those results are robust to the violation of the conditional independence assumption, to misspecification of the propensity score model, and that covariate balance is achieved. The results suggest that more efforts should be deployed to reduce the stigma associated with registration and to address the poor well‐being of FSWs, which is counterproductive to HIV prevention efforts.     

Understanding human sexual networks: a critique of the promiscuity paradigm

Increases in sexually transmitted infection (STI) and HIV rates worldwide have prompted the dedication of research to identifying transmission co-factors, with one such co-factor being an individual's number of different sexual partners. Currently, the majority of STI/HIV transmission models are based on the assumptions that sexual networks have random distributions; whereas, in real-life, these assumptions have proven incorrect because group norms produce variations in sexual practices and differences in transmission co-factors (i.e. number, type, and timing of sexual contacts, use of protection, and genital co-infections). In fact, sexual groupings follow the distribution of the scale-free network. Because human sexual assemblages form scale-free networks, a large number of sexual partners does not necessarily mean that an individual is at risk for acquiring an STI, or conversely, that a small number of partners means that an individual is not at risk. Therefore, while an individual's number of sexual partners is important for population-based and case-management initiatives, it is impossible to determine group sexual norms, network location, and γ values at the individual level. This signifies that a reliance on individuals’ number of different sexual partners to determine their need for STI/HIV testing may be an unnecessarily invasive practice that negatively impacts on testing practices. Thus, it is important to be aware that it is not so much this number of contacts that is important, but rather what occurs during these connections at a network level, and how many concurrent connections exist across the group.     

吸毒者艾滋病知识、行为及卫生服务利用调查

目的 了解广东省广州市吸毒人群的艾滋病相关知识、行为特征、性病感染和卫生服务利用情况.方法 采用横断面方法,对广州市某强制戒毒所的戒毒学员进行自填问卷调查.结果 433名戒毒学员对艾滋病的传播途径知晓程度相对较好,但对其他知识的知晓程度相对较差;75.9%发生过婚前性行为.入所前6个月与固定性伴侣、临时性伴侣、商业性伴侣和同性性伴侣发生过性关系的比例分别为62.1%,32.8%,16.2%和1.8%;发生性关系时每次均使用安全套分别占14.0%,19.0%,31.5%,12.5%;247人有静脉注射吸毒史,占57.0%.入所前6个月内有41人与别人共用过注射器,占静脉吸毒者的16.6%;女性性病率高于男性,差异有统计学意义 (χ²=14.326,P<0.001);有139人曾经接受过有关艾滋病预防措施的服务,占31.1%.结论 广州市吸毒人群对艾滋病相关知识有一定程度的了解,但普遍具有传播艾滋病的高危行为,且健康水平不高,艾滋病卫生服务利用率较低,应加强艾滋病的宣传、检测和咨询服务.     

兰州市重点人群预防控制艾滋病基本知识健康教育效果分析

目的　为制定适合甘肃省预防控制艾滋病易操作又效果好的健康教育方案提供科学依据。方法采用大众传播与人际传播相结合的方法 ,对兰州市大中专院校学生和宾馆、饭店、歌舞厅、酒吧等娱乐场所从业人员以及戒毒所、劳教所的劳教人员等重点人群进行健康教育。干预前进行 KAP基线调查 ,干预后进行 KAP效果终期调查。结果干预后通过广播电视、报刊、医务人员、宣传材料、朋友获取艾滋病基本知识的比例依次为 77.70 %、47.14%、36 .0 2 %、30 .0 2 %、13.5 0 % ,均较干预前有显著性提高 ,χ2值分别为 12 5 .5 3、6 38.96、194.47、15 .0 2、14.0 2 ,P值均小于0 .0 0 5。干预前综合知识得分为 6 6 .0 9分 ,干预后提高到 84.48分 ,差异有显著性 (Uc=5 0 2 .89,P<0 .0 0 0 5 )。除握手、拥抱不传播艾滋病一个问题外 ,对其他问题的正确回答率均有显著性提高 (χ2值为 12 .5 6～ 315 .5 6 ,P值均小于 0 .0 0 5 )。干预效果指数为 1.0 3～ 2 .5 9。结论综合性健康教育干预措施可明显提高重点人群预防控制艾滋病基本知识     

四川省HIV感染者/AIDS患者性行为特征分析

目的了解HIV感染者／AIDS患者(People Living With HIV and AIDS，PLWHA)的性行为现状及特征，为进行行为干预提供依据。方法在四川省资中县、昭觉县及西昌市对已确诊的PLWHA及其性伴、以及当地健康对照人群进行问卷访谈调查。结果资中县PLWHA中有15．0％的人有临时性伴。该比例在西昌和昭觉分别为57．9％和18．9％。在与固定性伴的性活动中，资中的36．8％PLWHA回答“经常使用”安全套；与临时性伴的性活动中。66．7％回答“从不使用”安全套。西昌地区的相应比例分别为65．4％和72．7％；昭觉为97．1％与100．0％。结论PLWHA的性活动较非PLWHA人群复杂，但该人群的性行为现状具有明显的共性，是行为干预和健康教育的突破口。推广安全套的使用尤为重要；应将防制HIV性传播工作的重心逐渐由城市移向乡镇。     

Young people, HIV/AIDS and the promotion of sexual health

In the lay and professional literatures on HIV and AIDS, youngpeople are frequently characterized as being at high risk ofinfection. Their social immaturity, their spontaneity, theiremotional volatility and their propensity to risk-take is saidto render them specially vulnerable. This paper questions theappropriateness of such a view and argues for a more sociallydifferentiated understanding of young people and their HIV/AIDShealth promotion needs. It reviews aspects of relevant Europeanepidemiology, describes dominant ideologies of youth and adolescenceand their impact upon HIV/AIDS work, and identifies key implicationsfor policy and practice.     

杭州市开发区流动人口艾滋病防治健康教育效果分析与评价

目的 了解杭州市开发区流动人口艾滋病防治知识的认知程度，评价对流动人口实施艾滋病健康教育的效果，为对流动人口实施艾滋病干预决策提供参考。方法 对开发区流动人口开展多种形式有关艾滋病防治知识的健康教育，包括艾滋病防治知识讲座、宣传版面展示、提供咨询、发放宣传资料、免费提供安全套等形式，在健康教育前后对流动人口进行问卷调查，对其健康教育前后艾滋病相关知识知晓程度进行比较。结果 被调查人员对问卷中13项艾滋病相关知识知晓率除“输血会传染艾滋病”健康教育前后没有统计学差异外，其他12项均存在显著性差异；健康教育后被调查对象对待艾滋病病人的态度与健康教育前比较有不同程度的提高和改善（P〈0．05）。健康教育后被调查对象“蚊虫叮咬不会传播艾滋病病毒”、“国家针对艾滋病的四免一关怀政策”两项知识的知晓率仍低于50％；对艾滋病病毒感染者和病人的态度正确率也低于50％。流动人口获得艾滋病相关知识的途径主要为电视（78．20％）、报纸和杂志（65．92％），喜欢的宣传方式主要为电视（58．13％）、报纸、杂志等（43．08％）。结论 健康教育能有效提高流动人口对艾滋病的认知程度，但被调查对象对艾滋病部分知识认知程度仍很低，应继续有针对性的加强该人群的艾滋病相关知识教育。     

HIV/AIDS患者合并机会性感染 与卫生服务利用现状分析

摘要:目的　分析HIV/AIDS患者合并机会感染与卫生服务利用的现状。方法　采用随机整群抽样对HIV/AIDS患者进行合并机会性感染及卫生服务利用问卷调查。结果　HIV/AIDS患者合并机会性感染率为57.78%;HIV/AIDS未合并机会性感染者和合并机会性感染者两周患病率分别为38.60%和73.08%,差异有统计学意义（P＜0.05）;HIV/AIDS未合并机会性感染者和合并机会性感染者两周就诊率分别为49.12%和76.92%,差异有统计学意义（P＜0.05）;HIV/AIDS患者家庭经济困难占64.71%,是他们未就诊的主要原因;HIV/AIDS患者选择医疗机构就诊差异有统计学意义（P＜0.05）;HIV/AIDS未合并机会性感染者和合并机会性感染者年住院率分别为15.79%和20.51%,差异无统计学意义（P＞0.05）;HIV/AIDS患者选择医疗机构住院差异无统计学意义（P＞0.05）。结论　HIV/AIDS合并机会感染者卫生服务利用量大于未合并机会感染者,HIV/AIDS患者卫生服务利用与医疗机构、病程、居住地、经济条件有关。     

中国50岁以上人群艾滋病疫情特点及流行因素分析

长期以来,15～49岁人群是HIV感染的高危及主要人群,但近年来我国艾滋病疫情报告系统显示≥50岁年龄组HIV感染者和艾滋病患者(HIV/AIDS)报告数及构成比有增多趋势.随着全球范围老龄化问题的出现,≥50岁年龄组人群的HIV感染状况开始引起社会关注[1].为了解我国中老年人群艾滋病疫情特点及流行因素,本研究对我国≥50岁年龄组HIV/AIDS报告病例进行分析.     

祥云县艾滋病抗病毒治疗取得明显成效原因分析

[目的]通过对祥云县艾滋病抗病毒治疗工作取得明显成效的原因进行分析，探讨出基层开展抗病毒治疗工作的有效方法，全面推进艾滋病抗病毒治疗工作。[方法]通过考察学习、召开会议、制定方案、协调部门配合、落实责任到人等一系列措施，祥云县艾滋病抗病毒治疗工作不断取得新进展。[结果]2005年开展抗病毒治疗2例；2006年开展抗病毒治疗9例；2007年开展抗病毒治疗41例，治疗覆盖面从2005年的33．33％上升到2007年的87．23％，顺利完成省级下达的任务指标。[结论]领导重视、方法得当、措施得力，是艾滋病抗病毒治疗工作不断取得新进展的关键。     

HIV/AIDS and cultural practices in western Kenya: the impact of sexual cleansing rituals on sexual behaviours

This paper reports on an exploratory study examining the role of sexual cleansing rituals in the transmission of HIV among the Luo community in western Kenya. Data were collected using both in‐depth interviews and focus group discussions. The study population consisted of 38 widows, 12 community elders and 44 cleansers. Data were collected on non‐behavioural causes, behavioural causes and behavioural indicators associated with sexual rituals. Content analysis revealed five central themes: the effect of the ritual on sexual behaviours; factors contributing to the continued practice of the ritual, including a sub‐theme on the commercialization of the ritual; the inseparable relationship between the sanctity of sex, prosperity and fertility of the land; and the effects of modernization on the ritual, including a sub‐theme on the effects of mass media on HIV‐prevention awareness campaigns. Causal factors of unchanging sexual behaviours are deeply rooted in traditional beliefs, which the community uphold strongly. These beliefs encourage men and women to have multiple sexual partners in a context where the use of condoms is rejected and little HIV testing is carried out.     

不同健康教育模式对黄浦区建筑工人艾滋病知信行干预效果评价

[目的]探索不同艾滋病健康教育干预模式应用在建筑工人中的干预效果,为制定针对此人群干预教育策略提供参考。[方法]采取随机抽样的方法抽取上海市黄浦区工期长且人员相对稳定的6个建筑工地,按随机方法分成低、中、高3个等级的干预组实施不同模式的干预;健康教育方法随干预等级提高趋于多样、专业。干预后6个月随访分析干预前后建筑工人艾滋病知信行的变化。[结果]干预前调查594人,干预后6个月随访到352人,随访率59.3%。在干预前对艾滋病知识有一定了解的建筑工人,干预后的得分与干预前比较,差异无统计学意义;而在干预前对艾滋病知识了解较少的建筑工人,干预后的得分与干预前比较,差异有统计学意义（3个干预等级P均≤0.001）。建筑工人干预前艾滋病知识知晓率仅62.2%,各干预等级之间差异无统计学意义;干预后知晓率提高,各干预等级差异有统计学意义（F=20.3,P〈0.001）,高度干预工地建筑工人艾滋病知识知晓率提高最多,达73.6%。在干预前多数建筑工人对艾滋病病人持＂同情＂态度,但也有＂害怕＂、＂厌恶＂的看法,各工地间差异无统计学意义;干预后建筑工人对艾滋病病人持＂同情＂态度有增加,持＂害怕＂、＂厌恶＂态度有所降低,工地间各干预等级差异有统计学意义（认可率：＂同情＂χ2=17.7,P〈0.05;＂害怕＂χ2=16.8,P〈0.05;＂厌恶＂χ2=16.2,P〈0.05）,高度和中度干预工地变化较大。但发生性关系时经常使用安全套者的比例各干预组干预前后差异无统计学意义。[讨论]对建筑工人开展形式多样的艾滋病健康教育对提高艾滋病知识和信念可行有效;健康教育的开展不仅要针对性强而且要坚持反复强化,使受教育者知行一致。     

第三轮中国全球基金艾滋病项目宣传干预效果分析

目的 分析第三轮中国全球基金艾滋病(AIDS)项目宣传干预效果。方法 调查分析各人群艾滋病知识知晓率及重点人群安全套的使用状况。结果 通过项目执行,项目地区中学生、城乡居民HIV感染者或AIDS病人(PLWHA)和女性性服务者(FSW)的艾滋病知识知晓率分别由2004年底的13.25%,23.4%,45.82%和13.84%分别上升到2006年底的45.70%,44.91%,69.39%和48.00%(P<0.001)。PLWHA的安全套使用率从2004年的39.8%上升到2006年的82.90%,FSW的安全套使用率维持在75%以上水平。结论 通过项目的推动,项目地区各人群的知晓率明显提高,重点人群的行为得到改变;但在很高的服务覆盖下,各人群仍有50%以上的人不了解艾滋病经性传播知识,重点人群安全套的使用率仍需进一步提高,因此需要针对人群特点调整宣传干预方法及策略以提高效果。     

Project AID Khmer: Addressing the health impact of HIV/AIDS on Cambodia through rural capacity building

Abstract

HIV/AIDS prevention efforts in Cambodia have largely focussed on urban populations. This focus, however, has diverted attention from the impact of the disease on rural communities, where poverty and a lack of basic infrastructure forced many to migrate to urban areas. Rural communities thus play a crucial part in the understanding of HIV/AIDS transmission dynamics in Cambodia. This paper will provide an analysis of socio-economic and health-related needs of rural communities in Cambodia, giving a different context for understanding the national burden of HIV/AIDS. These concepts will be illustrated with experiences from Project AID Khmer, a Cambodian non-governmental organisation that is working to improve Cambodian health through education programmes and community capacity building in rural Takeo province.     

广西低档场所中老年嫖客艾滋病相关知识对其商业性行为及HIV感染的影响研究

目的了解广西中老年男性嫖客商业性行为特征,研究该人群艾滋病知晓情况对商业性行为和HIV感染的影响。方法对低档暗娼场所≥50岁嫖客进行问卷调查获取基本社会人口学信息、商业性行为和艾滋病知晓情况,采集5m L静脉血检测HIV和梅毒抗体,使用PASW Statistics 18.0软件进行统计分析。结果本调查共获得有效问卷1 761份,中老年嫖客艾滋病防制知识知晓率为26.8%。知晓者与不知晓者相比,最近两周发生性行为(OR=1.60,95%CI:1.26~2.04)、首次找小姐的时间在2005年之前(OR=1.65,95%CI:1.32~2.06)、嫖娼年限≥10年(OR=1.61,95%CI:1.29~2.02)等行为发生的风险更高;最近一个月发生无保护性行为(OR=0.69,95%CI:0.55~0.86)和HIV阳性(OR=0.51,95%CI:0.25~1.07)等风险较低。结论广西中老年嫖客艾滋病知晓率较低,知道艾滋病防制知识的中老年嫖客商业性行为具有暴露起点早,时间跨度长,近期性行为较多等特点,但HIV感染率较低,发生无保护性行为较少,提高该人群艾滋病知晓率对降低HIV感染有积极的作用。     

Short-term physical and emotional health outcomes of public sector ART in the Free State province of South Africa

INTRODUCTION: In order to assess the health outcomes of the South African public sector antiretroviral treatment (ART) programme, it is important to gain a better understanding of the complex relationship between ART and the multidimensional construct quality of life (QoL). Because of the gap between supply and demand, equity issues arise concerning the provisioning of ART. OBJECTIVE: The aim of this paper is to examine how and to what extent public sector ART is related to the physical and emotional health of people living with HIV/AIDS (PLWHA). METHODS: The stratified random sample consisted of 371 AIDS patients on ART or medically certified for ART, but still awaiting treatment. A model of the relationships between patient characteristics (age and gender) and socio-economic position (educational level, income, type of dwelling, number of rooms), ART duration, and physical and emotional QoL was tested using structural equation modelling. RESULTS: Patients with a higher personal income (beta = .19, P < .05) and a larger dwelling (beta = .45, P < .01) were significantly more likely to enter the programme at this early stage. The model showed that the initial months of ART have been associated with significant improvements in the physical QoL (beta = .21, P < .01). Furthermore, patients on ART reported significantly higher levels of emotional well-being than patients awaiting treatment (beta = .10, P < .01). Finally, the results indicate that ART is not only directly associated with emotional QoL, but is also indirectly associated with emotional QoL via the mediating variable physical QoL (beta = .30, P < .01). CONCLUSIONS: The study suggests that the poorest of the poor are not the first beneficiaries of the public programme. Most importantly, the present findings demonstrate the positive physical and emotional health outcomes of the first 6 months of ART in the Free State, South Africa.